Nurse Burnout and Self-Care in the Modern Healthcare

Environment

A Term Paper Presented to Mrs. Eleonor Francisco of the

College of Bachelor of Science in Nursing
Calayan Educational Foundation Inc.

In Partial Fulfilment
Of the Requirements for the
SOC.SCI 102/The Contemporary World

ALVA, NICAROSE FE Q.
CRISTO, HECYVEL P.

APRIL 2024
TABLE OF CONTENTS

I. Introduction
II. History and Background
III. Extent of the Problem and Significance
IV. Scope of the Study
V. Limitations of the Study
VI. Significance of the Study
VII. Effect of the Problem/Benefits
VIII. Possible Solutions/Future Directions
IX. Conclusion
X. References
 INTRODUCTION

To explore the variables related to the quality of work life and the self-care of nursing
professionals working with high emotional demand. Professional burnout is a widespread
phenomenon in health care. The health of patients and organizations begins with the well-
being of health care professionals. Identifying and understanding self-care strategies that
professionals perceive to be helpful is crucial to combat burnout. The health of nurses impacts
the care of patients in healthcare settings today both inside and outside of hospitals. Many
papers are written about nurses’ burnout, depression, poor physical and mental health, weight
gain, unhealthy eating patterns, back injury, moral negativity, and lack of job satisfaction.
However, little attention has been paid to self-care in nurses. The goal of this paper is to
discuss the importance of nurses caring for themselves as they work under stressful conditions
regularly. Job satisfaction is necessary for nurses to have a healthy work-life balance and a
desire to go to work. There are evidence-based interventions that can make a difference in a
nurse’s quality of life that can be implemented independently or within the work setting.
Suggestions made by researchers include working less than 40 hr/week in a clinical setting,
working a consistent time of day without rotations, expressing emotions, taking time to
exercise, participating in a support group, and incorporating a place designated as a sanctuary
in the clinical setting. Personal ways to improve health includes preparing healthy meals before
working a shift, getting proper sleep, utilizing cognitive behavioral therapy, participating in
mindfulness training, and practicing stress reduction techniques. Self-care is critical in
minimizing the symptoms of burnout among human services professionals, but specific
information on the role of self-care among social workers in healthcare settings is limited. This
correlational study was designed provide a fuller understanding of this relationship. Orem’s
theory of self-care and the theory of reasoned action and planned behavior served as the
theoretical foundations of this study. The sample included 185 members of the National
Association of Social Workers, who volunteered to participate in this study. Participants
completed online versions of the Maslach Burnout Inventory and Self-Care Assessment Work
Sheet. Correlation and analysis of variance (ANOVA) were performed to test research
hypotheses concerning associations between self-care and aspects of burnout among social
workers in healthcare settings. The results showed that higher levels of self-care were
significantly correlated with lower scores on measures of emotional exhaustion and
depersonalization and higher scores on measures of personal accomplishment. No significant
differences were found by practice setting in mean ratings of specified self-care activities. More
years of social work practice were associated with lower burnout. Implications for positive
social change include highlighting the need for self-care to prevent burnout, promoting health
and wellbeing among social workers, and saving organizations the costs associated with
employee burnout. Future research on self-care and burnout will be beneficial to the profession
to expand current literature and highlight trends between social work practice and client
populations served.
 HISTORY AND BACKGROUND OF THE STUDY

A critical shortage of nurses currently threatens health care in America (Aiken, Clarke,
Sloane, Sochalski, & Silber, 2002). One of the causes of this shortage is that nurses
experience high levels of stress and burnout in acute care settings and leave for less-stressful
jobs (Medland, Howard-Ruben, & Whitaker, 2004). One study of more than 10,000 nurses
from five different countries found an incidence of burnout that ranged from 54% (United
States of America) to 32% (Scotland; Aiken, Clarke, & Sloane, 2002). The purpose of this pilot
study is to evaluate one approach to reduce stress and burnout in nurses.

Burnout is a psychological state that is characterized by a constellation of symptoms

including emotional exhaustion (EE), depersonalization (DP), and decreased perceptions of
personal accomplishment (PA; Maslach, Jackson, & Leiter, 1996). EE is the basis for burnout
leading to increased feelings of DP and decreased feelings of PA (Koeske & Koeske, 1989).
EE and burnout occur as a result of chronic exposure to environmental stressors in association
with ineffective coping resources (Folkman & Greer, 2000). Examples of environmental
stressors to which nurses are exposed on a regular basis are pain, suffering, death, ever-
changing technology, and challenging institutional and ethical issues (Fagerberg, 2004,
Maytum et al., 2004). To deal with the stressors, studies have reported effective and ineffective
coping mechanisms used by nurses. Examples of ineffective coping mechanisms practiced by
nurses are smoking, substance use and abuse, and overeating (American Nurses, 1984,
Dunn, 2005, Sarna et al., 2005). When exposed to chronic and significant stressors, nurses
who use ineffective coping strategies are at risk to develop the stress syndrome of burnout
(Medland et al., 2004).

A correlation exists between nurses identified as experiencing burnout and their reports of
fair–poor quality of care on their units, decreased job satisfaction, and increased risk of failure
to recognize patient distress (Aiken et al., 2002, Birkmeyer et al., 2004). Exploration of patient
satisfaction and nurse burnout suggests that elevated EE scores on the Maslach Burnout
Inventory (MBI) are associated with low levels of client satisfaction (Aiken, Clarke, Sloane,
Sochaliski, et al., 2002). Nurses whose own emotional reservoirs are low are less equipped to
meet the care needs of their patients, and this may negatively impact patient safety
(Laschinger & Leiter, 2006).

It has been well documented that workplace stress can have a negative impact on nurse
well-being and productivity, and can result in the syndrome of compassion fatigue, which is
comprised of secondary traumatic stress and burnout. Identifying effective and practical
workplace interventions to help improve nurse resilience to prevent compassion fatigue is
therefore a high priority. This study trialled the effectiveness of a brief mindful self-care and
resiliency intervention for nurses working in an Australian tertiary hospital compared to nurses
in a wait list control condition.

While compassion fatigue and its associated negative effects have been shown to be
problematic for nurses, not everyone exposed to workplace stress experiences negative
outcomes. Individuals that are more immune to stress have been described as “resilient”.
Resilience has been defined by the American Psychological Association (APA) as “the process
of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of
stress” (APA 2015, p.1). It is generally accepted that resilience is a multidimensional construct
made up of both trait-based aspects and skills that can be learned (Southwick and Charney
2012). For example, higher resilience is related to lower vulnerability for compassion fatigue
and burnout, and greater persistence in the nursing workforce (Hegney et al. 2015; Hodges et
al. 2010; Manzano García and Ayala Calvo 2012). Zeller and Levin (2013) have therefore
argued that interventions for nurses that focus on building psychological resilience and
adaptive coping to stress are vital if the worst effects of stress are to be avoided.

Maslach and Jackson (1981) defined burnout as “a syndrome of emotional exhaustion and
cynicism that occurs frequently among individuals who do work with people of some kind” (p.
99). Leatz and Solar (1993) also defined burnout as “a physical, emotional, and mental
exhaustion caused by long term involvement in situations that are emotionally demanding and
very stressful, combined with high personal expectations for one’s performance” (p. 116).
Maslach and Jackson (1986) explained that burnout syndrome is characterized by negative
attitudes about clients, decreased feeling of personal accomplishment, and negative self-
evaluation. Emotional exhaustion, depersonalization, and personal accomplishment are the
main burnout domains highlighted.

EXTENT OF THE PROBLEM AND SIGNIFICANCE

GENERAL OBJECTIVES: The general objective of this term paper is to explore nurse burnout
and the significance of self-care in the modern healthcare environment. It aims to examine the
causes and consequences of nurse burnout, analyze the role of self-care in mitigating burnout,
and provide recommendations for promoting self-care and addressing nurse burnout in
healthcare organizations.

SPECIFIC OBJECTIVES:

 to examine the research on the definition, causes, and effects of nurse burnout.

 to investigate the connection between organizational culture, job satisfaction, workload,

and nurse burnout.
  to investigate various self-care techniques and interventions that can improve nurses'
wellbeing and help them deal with burnout.

 to examine how self-care programs adopted by healthcare institutions affect job

satisfaction and burnout rates among nurses.

 to evaluate how well self-care initiatives and programs work at lowering burnout and
enhancing patient outcomes.

 to offer suggestions on how to encourage self-care and avoid burnout for nurses,
legislators, and healthcare organizations.

SCOPE OF THE STUDY

This research paper aims to contribute to the Global Nursing Field, particularly benefiting the
professionals at Calayan Educational Foundation Inc, by examining the causes and consequences
of nurse burnout, analyzing the role of self-care in mitigating burnout, and providing
recommendations for promoting self-care and addressing nurse burnout in healthcare
organizations.

LIMITATIONS OF THE STUDY

This research project has a narrow focus, as it will only look into the registered nurse who works at
Calayan Educational Foundation Inc. By focusing on this particular organization, we hope to offer a
thorough analysis of the factors that contribute to nurse burnout, as well as its causes and effects. We
also hope to shed light on how self-care can help mitigate burnout and offer suggestions for addressing
nurse burnout in healthcare settings. Data collection will be made easier by applying a quantitative
approach and using survey questionnaires. This methodological decision makes it possible to collect
numerical data in an organized manner, which makes it possible to analyze the participants' experiences
and perceptions in a structured manner after the seminar.
 SIGNIFICANCE OF THE STUDY
The aim of this study on nurse burnout and self-care in modern healthcare environments could be as
follows:

 Understanding Causes: This study can help in identifying the factors in nurses burnout,
this could include long working shifts, high patient to nurse ratio, emotional stress and
lack of support.
 Improve Patient Care: Burnout can lead to decreased quality of care for patient, by
addressing burnout nurses can provide best patient care possible.
 Retention of Nurses: Since burnout can lead to nurses resign in their jobs, understanding
and addressing causes of nurse’s burnout can help healthcare facilities retain skilled and
experienced nurses.
 Promoting Self-Care: This study will help emphasize the importance of self-care among
nurses. This can lead to development of programs that promote self-care and wellness
among nurses staff.
 Promoting a Healthy Work Environment: By addressing the issue of nurses burnout
during today’s era health care facilities can create a healthier and more productive
environment.

EFFECT OF THE PROBLEM/BENEFITS

The effects of the problem of nurses burnout and lack of self care in modern healthcare environments, as
well as the potential benefits of addressing these issues, can be substantial.

Effects of the Problem can be the following:

 Decrease Quality Of Care: Burnout can be a factor of decreased productivity and quality
of care that nurses will provide to patients, which can negatively impact patient health
outcomes. Nurses that are burnout may take more errors, leading to patient safety risks.
 High Turnover Rates: Burnout can lead nurses to quit their jobs, which can disrupt
continuity of care and increase cost of healthcare because of frequent hiring and training
of new staffs.
 Mental and Physical Health Problems: Stress and burnout can lead to mental health issues
including anxiety and depression, it can also be a factor of physical health problems such
as sleep disorders and weakened immune system.
Benefits of addressing these problems are the following;
 Improve Patient Care: By reducing burn out and improving self care, the quality of care
that nurses will provide to the patient can be improved.
 Increase Retention of Nurses: Addressing burnout can help to increase job satisfaction for
nurses, this can result in cost savings for healthcare facilities and improved continuity of
care for patients.
  Enhanced Mental and Physical Well-Being of Nurses: Promoting self care and addressing
burnout can lead to nurses improved mental health and physical health resulting reduce of
risk for serious health conditions and improving quality of life.

POSSIBLE SOLUTIONS/FUTURE DIRECTIONS

Addressing nurses burnout and promoting self-care in modern healthcare environments requires multi-
faceted approach. Here are some possible solutions and future directions;
Possible Solutions:
 Workload Management: Implement strategies to manage the workload effectively, like
balanced nurse to patient ratios and reasonable work hours.
 Support Systems: Establish strong support systems within the workplace, including peer
support and accessible mental health resources.
 Training and Education: Provide training and education on recognizing the signs of
burnout and effective coping strategies.
Future Directions:
 Research: Conduct further research on the effectiveness of different interventions for
reducing burnout and promoting self care among nurses.
 Technology: Explore us of technology to reduce the workload and stress, for example
the telemedicine for remote care and digital tools for stress management and self care.
 Cultural Change: Work towards a cultural change in healthcare that values self-care
and mental health as much as productivity and patient care.

CONCLUSIONS

As nurses work to optimise their own self-care and navigate their career paths, they face inevitable
challenges to their well-being, such as burnout. A culture of wellness goes beyond basic self-care
activities to allow nurses to reach their full potential of health. This culture is inherent in the World
Health Organization’s definition for mental health: “A state of well-being in which every individual
realizes his or her own potential, can cope with the normal stresses of life, can work productively and
fruitfully, and is able to make a contribution to her or his community" (World Health Organization,
2014, para.1). ( A culture of wellness goes beyond basic self, care activities to allow nurses to reach
their full potential of health. ) Nurses are motivated people with extensive healthcare knowledge; yet
they need support to translate this information into action. As a profession, nursing leaders can help by
continuing to develop programs specific to supporting healthy behaviors in the workforce, programs that
then need to be studied and replicated. The components of the Mayo Clinic course “Optimizing Provider
Potential” are relatively straightforward; similar courses/programs could be developed locally to engage
nurses in peer support in their quest to optimize lifestyle changes. Simple health behaviors regarding
nutrition, sleep, and exercise are possibly more challenging for nurses even than their other health
professional colleagues. Nurses are not invincible; like everyone else they are susceptible to the drain of
daily stressors. A career in nursing, while rewarding, includes multiple demands placed upon nurses and
often a lack of adequate control over these daily burdens. Many nurses tend to take on multiple roles and
tasks, and commitment to simple health behaviors can become even more challenging. However, nurses
can engage in self-care, and at least metaphorically approach an aura of invincibility, by reaffirming
their individual commitments to the basic activities of healthy life, namely adequate nutrition, sleep, and
exercise. Developing effective self-care strategies helps promote health care professionals’ physical and
psychological well-being and reduce burnout. It is vital for health care professionals to care for
themselves so that they can best care for others.

REFERENCES

Quality of work life and self-care in nursing staff with high emotional demand - ScienceDirect

Self-care Strategies to Combat Burnout Among Pediatric Critical Care Nurses and Physicians | Critical Care Nurse | American
Association of Critical-Care Nurses (aacnjournals.org)

Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout -
ScienceDirect

Evaluating the Effectiveness of a Brief Mindful Self-Care and Resiliency (MSCR) Intervention for Nurses: a Controlled Trial |
Mindfulness (springer.com)

Nurse spiritual self-care: A scoping review - ScienceDirect

The Relationship of Self-Care to Burnout Among Social Workers in Health Care Settings - ProQuest

Developing a Course to Promote Self-Care for Nurses to Address Burnout - ProQuest

Evaluating the Effectiveness of a Brief Mindful Self-Care and Resiliency (MSCR) Intervention for Nurses: a Controlled Trial |
Mindfulness (springer.com)

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